Amid a shortage of family planning commodities, including birth control shots and implants, health facilities across the country are reporting a sharp rise in abortions.

According to data provided by the Ministry of Health and Population, 105,099 women terminated their pregnancies in the fiscal year 2023-24, up from 94,463 in the fiscal year 2022-23.

In the fiscal year 2021-22, a total of 90,733 women underwent abortion, while the number stood at 79,972 in the fiscal year 2020-21.

Altogether, abortion rates have increased by over 31 percent in the past four years, according to the government figure.

The Post had published multiple reports on the lack of family planning commodities in state-run health facilities across the country. These include Depo-Provera, a popular birth control shot for women; intrauterine devices, which health workers insert into the uterus; implants; and other contraceptives such as condoms, pills, and emergency pills.

Family planning experts say access to the commodities has a direct link to the rise in unintended pregnancies. They said the rise in unintended pregnancies not only increases abortion rates, but could also raise maternal mortality, which will be a serious blow to the achievement the country has made in maternal health over the years.

“There is a rise in unintended pregnancies when people don’t get family planning services when they need them,” said Dr Naresh Pratap KC, head of the Family Planning Association of Nepal. “This in turn contributes to an increase in the abortion rate—and not all abortions are carried out legally by trained professionals.”

Despite the legalisation of abortion in Nepal, which contributed significantly to a decline in maternal mortality, the majority of abortions continue to be provided by untrained providers or induced by pregnant women themselves, reports say.

Many women and girls still face considerable structural and informal barriers to accessing safe abortion services in Nepal.

Abortion was legalised in Nepal in 2002, a milestone for women’s reproductive rights, their empowerment, and their right to bodily autonomy. The government provides free abortion services and travel allowances through many state-run health facilities across the country.

Pregnant women can seek termination of their pregnancy of up to 12 weeks, and service providers have to help them without questioning.

The Safe Motherhood and Reproductive Health Rights Act, endorsed by Parliament in 2018, allows abortion of up to 28 weeks in case of rape, incest, serious health risk to the mother, or if the foetus is found to have genetic defects.

However, abortions after 12 weeks require medical certification. Doctors must certify that pregnancy poses a big risk to the woman’s life or could seriously affect her mental or physical health, that the foetus will be born with deformities, or that the woman is infected with HIV or similarly incurable diseases.

With legalisation, persecution and jail terms for women who terminated unwanted pregnancies ended, and unsafe abortions decreased dramatically.

Consequently, between 1996 and 2016, Nepal’s maternal mortality rate fell from 539 to 239, helping it achieve the Millennium Development Goal—a feat for which the legalisation of abortions played a significant role, doctors say.

Nearly half of the pregnancies in Nepal are unintended and close to two-thirds of them end in abortion, according to a report by the United Nations Population Fund. The UNFPA’s “State of World Population 2022” report titled, “Seeing the Unseen”, says half of the 1.2 million pregnancies in 2017 in Nepal were unintended and nearly 359,000 were aborted.

Though we can estimate healthcare costs, monitor school dropout rates and project levels of workforce attrition due to unintended pregnancies, these only scratch the surface, the report says. No number could adequately represent the loss of life, agency and human capital that result from these pregnancies, according to the report.

The report also stated that about 44 percent of women of reproductive age in Nepal who want to avoid a pregnancy are not using a modern contraceptive method.

Use of modern methods of contraception among married women of reproductive age stands at 43 percent, leading to high rates of unintended pregnancy and unsafe abortion. Half of contraceptive users discontinue use within 12 months, according to the report, adding that unintended pregnancy is often linked to violence.

About 13 percent of ever-partnered women and girls, aged 15 to 49 years, have been subjected to intimate partner violence in the past 12 months, according to the report.

The report shows that unintended pregnancies impose additional social and fiscal burdens, including through greater demand for healthcare, unsafe abortion, loss of income and productivity, fewer resources for children in a family, and more fraught and unstable family relationships.